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Urban Health: The Confusion and BUHN’s Role

The ground reality of urban health is the remarkable inadequacy of public facilities and service provisions. The void has encouraged private investments to reap robust returns and their activities continue to be largely unregulated. The quality and adequacy of their services remain problematic.

Both the current Health Policy and the Sixth 5-Year Plan recognize the importance of urban health due to the demographic transition taking place. The Urban Primary Health Care Project (UPHCP) of the Local Government Division (LGD), now completing its second phase, is seen to be the strategic response of the government to meeting urban population’s Health, Population and Nutrition (HPN) needs. The provision of PHC services through contracted NGOs was pioneered by USAID’s NSDP; its Smiling Sun franchise also builds on that approach. BRAC’s Manoshi Program again is a separate but substantial response to meeting urban public health needs. There is thus a multiplicity of interventions and the overall picture is fractured, in the absence of common or comparable MIS data generated by each of these programmes. The Ministry of Health and Family Welfare can play a stewardship role in identifying priorities for urban health, providing quality standards and ensuring compliance. It can also coordinate a common minimum cluster of MIS data which will assist policy review and decision-making for action.

Ministry of Health and Family Welfare’s (MoHFW) on-going HPNSDP reflects the Ministry’s modest plan budget for Urban Health in the OP on ESD( component 3 ). The identified activities include among others the development “of an urban health strategy and an urban health development plan in collaboration with MoHFW”. This confusion about a national strategy needs to be reconciled.

I assume that BUHN has a legitimate interest in contributing to the early adoption of a national urban strategy and realistic urban health development plan to meet the HPN challenges of the fast expanding urban population, particularly the needs of the poor and the marginalized.

The Programme Implementation Plan (PIP) of HPNSDP as approved by the government’s highest policy making body – the Executive Committee of the National Economic Council (ECNEC) – has the following entry under activities for the OP on ESD (in component 3): “Directorate General of  Health Services (DGHS) will support Bangladesh Urban Health Network (BUHN) in performing advocacy, knowledge-sharing and awareness raising activities”. BUHN is likely to follow up with concrete proposals on this offer.

Author: M.M Reza, Former Secretary
Ministry of Health and Family Welfare

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